二尖瓣瓣环位移评价病毒性心肌炎患儿左室收缩功能  

Left Ventricular Systolic Function Assessment by Mitral Annular Displacement in Children with Viral Myocarditis

作　　者：郑敏娟[1] 张华[1] 马慧[1] 朱晓丽[1] 刘珍[1] 刘丽文[1] 苏海砾[1] 

机构地区：[1]解放军第四军医大学西京医院超声科,西安市710032

出　　处：《中国超声医学杂志》2013年第6期489-491,共3页Chinese Journal of Ultrasound in Medicine

基　　金：陕西省社发公关资助项目(No.2011K12-22)

摘　　要：目的应用二维斑点追踪技术(STI)测定心肌炎患儿的组织二尖瓣瓣环位移(TMAD),探讨该指标评价左室整体收缩功能的可行性和准确性。方法研究对象为63例临床确诊的病毒性心肌炎患儿与45例正常同龄儿童,常规超声心动图测量左室LVEDD、LVESD、EF、FS,同时STI技术测定收缩期二尖瓣瓣环向心尖方向的位移TMAD,并进行相关分析。结果心肌炎分为两组:左室重构组LVEDD、LVESD、EF、FS与对照组差异有显著性意义(P<0.05),构型正常组与对照组差异无显著性意义(P>0.05),但两组TMAD与对照组差异均存在显著性意义(P<0.05);TMAD与EF相关性良好(构型正常组、重构组、对照组r值分别为0.79,0.65,0.74,P<0.05);用测定收缩期二尖瓣瓣环中点位移距离6.4 mm作为一个截断值,预测LVEF≤50%的敏感性为73%,特异性为71%。结论 TMAD指标可及时反映病毒性心肌炎早期左室收缩功能变化,STI技术测定二尖瓣瓣环位移是一种快速可靠、简便的评价左室整体收缩功能的新方法。Objective The goal of this study was to examine the feasibility and accuracy of mitral annular dis placement based on speckle tracking in assessing viral myocarditis children＇s left ventricle （LV） global function. Meth- ods 63 children confirmed with viral myocarditis and 45 healthy children were enrolled in this study. Left ventricle systolic function derived by routine echocardiography. And tissue mitral annular displacement （TMAD） in long axis were recorded by speckle tracking imaging （STI）. Correlation between TMAD and left ventrieular ejection fraction （LVEF） were analyzed. Results There was significant difference in LVEDD, LVESD, EF and FS between viral myo- carditis group with LV remodeling and healthy group （P（0.05）, but no significant difference between myocarditis group with normal LV geometric pattern and healthy group （P）0.05）. However, TMAD showed difference between the two sick and healthy groups （P〈0.05）. TMAD correlated well with EF in each group （r=0.79, 0.65, 0.74 re speetively, P〈0.05）. 6.4 mm could be used as cut-off value in TMAD predicting LVEF ≤ 50% via ROC curve, with sensitivity 73% and specificity 71%. Conclusions This study demonstrated TMAD could indicate the early change of LV systolic function in viral myocarditis children. TMAD derived By STI is a feasible and reliable method in evaluating LV systolic function.

关 键 词：二尖瓣 左室功能 超声心动图 二维斑点追踪技术 

分 类 号：R540.45[医药卫生—心血管疾病] R725.4[医药卫生—内科学]